Medicare Needs Your Help Creating Cost Measures
By David Doolittle


Have you reviewed MIPS cost measures for 2018 and thought, “Why didn’t anyone consult me when they created these?”

Well, now someone will.

The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, are field testing 13 cost measures before considering their potential use in the cost performance category of the Merit-Based Incentive Payment System (that’s MIPS if you were confused above) of the Quality Payment Program (QPP) in 2020 and beyond.

If you’re interested in participating, you’ll be asked to provide feedback on the measures and supplemental documents through Nov. 5 — the deadline has been extended from Oct. 31. For example, tell CMS your thoughts on how the cost measures attribute costs to you and whether they are fair and accurate and account for factors that are out of physician control. The Texas Medical Association encourages all physicians to weigh in.

So what are the measures? 

Well, 11 are under development:  

  • Acute Kidney Injury Requiring New Inpatient Dialysis
  • Femoral or Inguinal Hernia Repair
  • Elective Primary Hip Arthroplasty
  • Hemodialysis Access Creation
  • Inpatient Chronic Obstructive Pulmonary Disease (COPD) Exacerbation
  • Lower Gastrointestinal Hemorrhage
  • Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels
  • Lumpectomy, Partial Mastectomy, Simple Mastectomy
  • Non-Emergent Coronary Artery Bypass Graft (CABG)
  • Psychoses/Related Conditions
  • Renal or Ureteral Stone Surgical Treatment  

And two are being re-evaluated:  

  • Total Per Capita Cost (TPCC)
  • Medicare Spending Per Beneficiary (MSPB) clinician  

(Be aware these are not the same measures currently in use for the 2017 and 2018 MIPS performance periods and will not affect any scoring or payment adjustments in MIPS.)

For complete details, such as FAQs, draft measure specifications, how to access your Field Test Report(s), and other supplemental documents, visit the CMS MACRA Feedback page.

You can also get more information during a MACRA Cost Measures Field Testing Webinar scheduled for noon to 1:30 pm Tuesday.

If you have questions, contact the QPP Service Center at (866) 288-8292 or qpp[at]cms[dot]hhs[dot]gov.

And, as always, you can get the latest MACRA/QPP/MIPS information on the TMA website MACRA Resource Center.

Last Updated On

October 30, 2018

Originally Published On

October 08, 2018

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David Doolittle


(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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